Case study for healthcare-ethical and legal perspectives

Essay Help

Please read the case analysis and grading rubric. Read the case again! Go to the library and research for applicable peer reviewed scholarly material to help you answer the 4 discussion questions. Remember, at this level of your education, you should be a whiz at research. You are not the expert here, so in-text citations are expected to back up every statement or assumption you make when answering the questions of the case.

The case must be written in APA format with a minimum of four (4) current scholarly references (textbook does NOT apply), with in-text citations and no more than 4 pages. Your paper will have 4 headings – 1 for each question.

Case Study #1

Alleged improper admission orders resulting in morphine overdose and death

There were multiple co-defendants in this claim who are not discussed in this scenario. Monetary amounts represent only the payments made on behalf of the nurse practitioner. Any amounts paid on behalf of the co-defendants are not available. While there may have been errors/negligent acts on the part of other defendants, the case, comments, and recommendations are limited to the actions of the defendant; the nurse practitioner.

The decedent patient (plaintiff) was a 72 year old woman who had been receiving hospital care for acute back pain resulting from a fall. Her past history included chronic pain management and end-stage renal disease for which she received hemodialysis. She was to be transferred to the co-defendant nursing facility for reconditioning and physical therapy prior to returning to her home.

The nurse practitioner (defendant) was on-call at the time of the patient’s transfer, and the nursing facility contacted her and read the orders to the defendant nurse practitioner over the telephone. The defendant nurse practitioner questioned the presence of two morphine orders for different dosages with both dosages

administered twice daily. She instructed the nurse to clarify the correct morphine dosage with the transferring hospital’s pharmacist and to admit the patient only after the pharmacist clarified and approved the morphine orders. The defendant nurse practitioner had no further communication with the facility and no other involvement in the patient’s care. The facility nurse telephoned the hospital pharmacist who approved both morphine orders, and the patient was admitted to the nursing facility.

During the first evening and full day of her nursing facility stay, documentation revealed the patient to be alert and oriented. On the second day, she was found by nursing staff without vital signs. Despite immediate chest compressions and EMS additional resuscitation measures, the patient was pronounced dead. The autopsy results listed the cause of death as morphine intoxication. Surprisingly, the patient also had an elevated blood alcohol level (equal to drinking three to four alcoholic beverages). Because the source of the alcohol could not be identified, the medical examiner was unable to rule out accident, suicide or homicide and classified the manner of death as undetermined.

Resolution

Defense experts found the nurse practitioner’s actions to be within the standard of care.

Defense experts stated that the patient’s final morphine blood levels, even considering her renal disease, could not have resulted from the amount of morphine ordered, administered and recorded in the patient’s health information record. The elevated morphine and alcohol levels led experts to the opinion that the patient may have ingested morphine and alcohol from a source other than the nursing facility. This question was never resolved.

A motion for partial summary judgment for the defendant nurse practitioner was denied by the court and the decision was made to proceed to trial. After the completion of testimony but prior to receiving the verdict the co-defendants settled the case with no liability attributed to the defendant nurse practitioner.

Discussion

1. Summarize the case and the verdict.

2. Based on your review, do you agree with the court’s decision? Defend/discuss your answer.

3. What practice-related standard of care issues were breached.

4. Identify a risk management action plan to prevent this type of issue(s) from reoccurring.

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July 1, 2023

51.How can endurance athletes best postpone fatigue during their activity?

a.eat glucose periodically during the event

b.avoid sports drinks during exercise

c.fat load 1-3 days before the event

d.restrict fat calories to less than 20 percent of the diet

52.Calculate the calories needed from fat each day for a triathlete who requires 4500 calories a day.

a.550-700

b.750-875

c.900-1575

d.1580-1650

53.Protein is needed by the body to support an exercise program because of its role in:

a.contributing a major part of fuel in strength training.

b.sparing carbohydrate from being used for fuel.

c.repairing muscle tissue after exercise.

d.being converted to glycogen for storage in muscles.

54.Which of the following athletes would use the least protein for fuel during exercise?

a.Joe, who consumes a protein-rich diet

b.Charles, who consumes a fat-rich diet

c.Gary, who consumes a carbohydrate-rich diet

d.Rick, who consumes a diet rich in branched-chain amino acids

55.A high school football player is eating enough protein foods in his diet to provide him with 2.5 grams per kg of his body weight. What type of benefit will he get from his high protein intake?

a.This exceeds the recommendation for his sport so he should consider trading carbohydrate for some of the protein.

b.Although this exceeds the recommendation for his sport he will benefit from the additional protein as the body converts it to muscle mass.

c.This is an extremely toxic level that may cause serious health problems.

d.His body will adjust to the higher protein intake to require that amount on a regular basis.

56.Calculate the recommended daily protein intake for a female marathon runner weighing 126 pounds.

a.46-50 g

b.69-80 g

c.88-92 g

d.92-97 g

57.Calculate the protein needed by a male runner weighing 152 lb who is training for an upcoming competition. He participates in sprints and hurdling races.

a.55-76 g/day

b.83-117 g/day

c.83-97 g/day

d.117-138 g/day

58.An athlete takes vitamin and mineral supplements prior to competition because he believes they can enhance performance. You will explain to him that taking these supplements:

a.does not improve performance because there is not enough time for the nutrients to be combined with other appropriate parts so they can do their work.

b.is supported by research and advocated by health care professionals.

c.is beneficial because athletes tend to be deficient in vitamins and minerals.

d.improves performance because the nutrients flood the bloodstream during competition.

59.What would you tell a female long distance runner who is considering whether or not to begin taking an iron supplement?

a.She should avoid iron supplements because of possible problems with iron overload.

b.She needs to have medical testing of her blood iron values first to see if she needs it.

c.If she is on a vegetarian diet she is iron deficient and needs a supplement.

d.As a female endurance athlete she is definitely iron deficient and needs a supplement.

60.An athlete is in the early weeks of an aerobic training program and develops a decrease in hemoglobin concentration. Which of the following is true?

a.The condition is called sports anemia.

b.It probably reflects a low iron intake.

c.It goes away by itself.

d.a and b

e.a and c